Colorado’s public policies regarding the use of medical marijuana are a complete mess — and as the medical director of a busy adolescent substance abuse treatment program in Denver, I get to contend with this mess every day.

Take, for example, the 19-year-old whom I have treated for severe addiction for several months. He recently showed up in my clinic with a medical marijuana license. How did he get it? Easy, he said. He paid $300 for a brief visit with another doctor to discuss his “depression.” The doctor took a cursory medical history that certainly didn’t involve contacting me.

The teenager walked out with the paperwork needed not only for a license to smoke, but also for a license permitting a “caregiver” to grow up to six marijuana plants for him. My patient, who had quit using addictive substances after a near-death experience, is back to smoking marijuana daily, along with his caregiver.

So, that’s just one young person who managed to game the system, right? Not by a long shot.

In the last three months, I have seen more than a dozen young people — all between the ages of 18 and 25 and with histories of substance abuse — who received from other doctors what are essentially permission slips to smoke pot. Some of my colleagues recently reported seeing a young, pregnant woman who was granted a license to smoke marijuana because of her nausea. (Yes, you read that right.) Kids without licenses tell me about the potent pot they buy from caregivers whose plants yield enough supply to support sales on the side.

Colorado schools are also scrambling to make sense of our muddled public policies. Educators ask me how to deal with students who have marijuana prescriptions for their attention-deficit/hyperactivity disorder and with the “medical marijuana specialists” seen passing out business cards in student parking lots. Here’s what I tell them: Good research shows that using marijuana makes anxiety, depression and ADHD worse, so let’s stop prescribing marijuana to our youth.

Colorado is just beginning to see much bigger and more costly problems associated with teen marijuana smoking. That’s particularly unfortunate because our state already ranks among the top five for adolescent marijuana use and among states providing the least access to adolescent substance abuse treatment.

For teenagers, marijuana is an especially addictive drug. Nationally, almost 5.5 percent of high school seniors smoke marijuana daily, according to researchers at the University of Michigan. About 95 percent of the hundreds of young people referred to my clinic each year have problems with marijuana. I see teenagers who choose pot over family, school, friends and health every day. When they’re high, these young people make poor choices that lead to unplanned pregnancies, sexually transmitted diseases, school dropouts and car accidents that harm innocent people. When teenagers are withdrawing from marijuana, they can be aggressive and get into fights or instigate conflicts that lead to more trouble.

Now, almost every day, a kid asks me, “Doc, how can marijuana be bad? It’s a medicine.”

I recently reviewed medical marijuana licenses in Colorado and found that only 3 percent belong to people with cancer and 1 percent to people with HIV. Those illnesses are not open to much interpretation; you’ve either got them or you don’t. However, a whopping 90 percent of Colorado’s medical marijuana licenses have been awarded for “pain,” which is a highly subjective qualifying condition that makes it easy to abuse the system. Also interesting is that 70 percent of Colorado’s medical marijuana prescriptions are for men, and the biggest age group of licensees is 25- to 34-year-olds.

Medical marijuana in this state is not being prescribed for end-stage illnesses. Instead, it is being handed to the demographic most likely to have addictions.

The medicinal value of smoked tetrahydrocannabinol — marijuana’s active ingredient — has hardly been studied in controlled trials, which is why the American Medical Association recently called for more research. In the absence of credible data, we’re allowing this public debate to be bombarded by junk science and blatant lies championed by people more interested in getting high than in alleviating the pain of end-stage illness.

Medically speaking, there’s probably little need for smoked marijuana. Tetrahydrocannabinol has been available as a pill for years. For patients too nauseous to take a pill, a tetrahydrocannabinol patch has been produced and studied but is not yet available for prescription. The pill and patch have been deemed effective, produce less intoxication and are far less addictive than smoked marijuana.

With such limited data, it’s incredible that marijuana bypassed FDA approval and the way medications are normally dispensed in pharmacies. It is ridiculous that this “medicine” can be sold in an array of flavors alongside pot brownies and candies. Also stunning is that marijuana has bypassed the Colorado Prescription Drug Monitoring Program, which enables me to look up all of my patients’ prescriptions. Now, I can see all of their meds — except for their marijuana.

What Colorado has created is a backdoor way to legalize marijuana, and it has done so in a manner that makes a mockery of responsible medicine.

Let’s stop talking in terms of smoked marijuana’s medicinal value because we’re not even close to knowing what that is. Let’s instead answer the question that’s truly at the heart of all of this political wrangling: Is smoking marijuana a civil right?

Before answering that question, Colorado should carefully study the social costs of accidents, aggression, school dropouts, STDs and teen pregnancy that will inevitably be the result of increased marijuana use. No medication — not even marijuana — is without side effects.

Christian Thurstone is a board-certified child/adolescent and addictions psychiatrist who conducts federally funded research on marijuana addiction in teenagers.

Source: http://www.denverpost.com/commented/ci_14289807 1.3.2010